Many people who suffer from COPD also struggle with anxiety. When you have trouble breathing your brain triggers a response to warn you that something is wrong which can cause panic and sensations of anxiety. Also people find they suffer anxiety due to worrying and being stressed about the condition and prognosis as the disease worsens as well as being linked to depression which many COPD patient’s suffer from. Medications used to treat COPD can also trigger anxiety too.
The Breathlessness-Anxiety Cycle
It is often a vicious cycle where feeling breathless can cause panic and anxiety, which in turn makes it more difficult to breathe. This cycle can be difficult to break and the symptoms of COPD become indistinguishable from the symptoms of anxiety. Many are confused and make lots of trips to the doctors. Many people avoid enjoying social and leisure activities that can cause breathlessness out of fear from potentially experiencing anxiety that may be caused.
Having some degree of anxiety when you have a chronic disease can be a good thing. It can make you pay attention to your symptoms and follow your treatment plan. It can also warn you when you need to seek medical attention, but too much anxiety can severely impact the quality of your life.
Coping With Anxiety
Coping with anxiety can be tricky especially as many medications have a negative impact on your health if you are suffering with COPD as they can cause decreased rate of breathing and interact with other COPD medications.
Your doctor can help you to determine what medication will work best for you. Some people with COPD find relief with non-addictive anti-anxiety medications which don’t interfere with breathing.
Medications are helpful but their effectiveness will be increased by other means of reducing anxiety. Ask your doctor about referral to a pulmonary rehabilitation program, where you will receive education about COPD and get help with coping strategies to deal with your anxiety. One of the most important things that you learn in pulmonary rehabilitation is how to breathe more effectively.
Breathing techniques such as “pursed lip breathing” can help to take the work out of breathing, slow your breathing down, keep your airway open for longer—and help you to relax. To do pursed lip breathing, you simply relax your upper body, and then breathe in slowly through your nose to the count of two. Then with lips pursed as if you were going to whistle, you breathe out slowly through your mouth to the count of four.
Many people with COPD find that individual counselling is effective in reducing anxiety. One common type of therapy called cognitive behavioural therapy helps people with anxiety symptoms decrease them through learning relaxation techniques and breathing exercises.
Group counselling, such as support groups can also help you to learn how to cope with COPD – and your anxiety – and being with others who have some of the same problems can help you to feel less alone.
Many find that if they are in the breathlessness/anxiety cycle then by immediately treating the breathlessness can instantly lessen the feelings of anxiety. By having a portable oxygen concentrator you have access to your oxygen wherever you are, whatever you’re doing and if needed can use it when you are feeling short of breath. Knowing that you have the portable concentrator to hand can also in itself reduce your anxiety levels and help prevent episodes as you have that security and peace of mind that if your anxiety or COPD symptoms suddenly flare up that you have something close to hand to instantly resolve it.
If you’ve been prescribed oxygen therapy, it’s because your blood oxygen level is low. Low oxygen levels can potentially damage your heart or brain.
The main purpose of home oxygen treatment is to raise your blood oxygen to a level that prevents such harm. It also helps relieve breathlessness and other symptoms of low blood oxygen, such as ankle swelling and blue lips.
However, using oxygen just for relieving symptoms of breathlessness is not helpful and can cause long term harm by making you less fit. This can also cause a delay in finding out why you are breathless.
How home oxygen treatment can help
If you have a medical condition that leads to a low oxygen level in your blood (hypoxia), you may feel breathless and tired, particularly after walking or coughing. You may also have a build-up of fluid around your ankles (oedema) and blue lips.
Breathing air with a higher concentration of oxygen can help increase the amount of oxygen in your blood. This makes it easier to do activities that might otherwise be more difficult. It also helps reduce the symptoms mentioned above.
Oxygen therapy can help people with a range of health conditions that affect breathing or blood circulation, including:
- chronic obstructive pulmonary disease (COPD) – a long-term disease of the lungs
- severe long-term asthma
- cystic fibrosis – an inherited disease that causes the lungs to become clogged with thick, sticky mucus
- pulmonary hypertension – high pressure inside the arteries to the lungs, which causes damage to the right-hand side of the heart
- obstructive sleep apnoea – a condition that causes interrupted breathing during sleep
- diseases of the nerves and muscles or ribcage
- heart failure – when the heart struggles to pump enough blood around the body
People who have oxygen therapy have different requirements. Some people only need oxygen therapy for short periods during the day, when they’re walking about (ambulatory oxygen). Others need it for longer periods and during the night.
Different types of home oxygen
Oxygen can be obtained from:
- compressed oxygen cylinders
- liquid oxygen in cylinders
- an oxygen concentrator machine, which extracts oxygen from the air
If you just need oxygen for short periods to relieve attacks of breathlessness after an illness, you will probably be prescribed oxygen cylinders. However, this should be reviewed after a certain time so that the short-term relief does not hide more serious underlying heart or lung conditions. If your blood oxygen levels are normal for you during a review, that short-term oxygen should be withdrawn.
You breathe the oxygen through a mask or through soft tubes in your nose, called nasal cannulae. You can talk, eat and drink while using cannulae.
Cylinders containing oxygen compressed into liquid form can contain more oxygen than standard cylinders. This type of oxygen supply will last for longer, and the tank may also be lighter.
Oxygen concentrator machine
An oxygen concentrator machine is convenient if you would benefit from having oxygen for a large number of hours a day, including while you’re asleep. It ensures you have a source of oxygen that never runs out.
An oxygen concentrator is a machine, about two-and-a-half feet (75cm) high, which plugs into your electrical socket. It filters oxygen from the air in the room and delivers it through plastic tubing to a mask or nasal cannulae.
Long tubing can be fixed around the floor or skirting board of your house, with two points where you can “plug in” to the oxygen supply.
When the machine is installed, the engineer or nurse will discuss with you the length of tubing you’ll need. The machine is very quiet and compact, and the engineer will explain how to use it and will answer any questions you have.
A back-up cylinder of oxygen is also provided in case the machine breaks down. Regular maintenance visits will be made to make sure the concentrator is always working properly.
Portable (ambulatory) oxygen
If you’d like to have a small portable cylinder to take oxygen outside your home, talk to your specialist. You’ll need to be fully assessed to see whether portable oxygen (also known as ambulatory oxygen therapy) is likely to be helpful.
Portable oxygen is not recommended if you have heart failure or if you smoke.
Portable cylinders can provide oxygen at a rate of 2 litres or 4 litres a minute, or have an adjustable scale up to 4 litres a minute. The flow required is determined by your lung specialist or the oxygen service healthcare professional. When full, these cylinders weigh just over five pounds (2.3kg) and hold just under two hours of oxygen (at 2 litres a minute).
Going on holiday
If you are going on holiday in England or Wales, talk to your supplier to see if you can make arrangements to have home oxygen supplied to you at your destination. Try to give them as much notice as possible.
Before you arrange your holiday, check with your doctor that you are well enough to travel.
Oxygen is a fire hazard and, if you are supplied with home oxygen, it is important to take precautions.
do not let anyone smoke while you are using oxygen
keep away from flammable liquids while using oxygen – these include alcohol gel, cleaning fluid or aerosols
keep oxygen at least six feet away from flames or heat sources
keep oxygen cylinders upright to avoid them getting damaged
Your home oxygen supplier is also likely to let the local fire service know that there is oxygen in your home. They may request a risk assessment, even if you do not smoke.